[Clinical analysis of 42 cases of primary malignant tumor in vagina].

OBJECTIVE: To analyze the clinical characters, treatment and prognosis of primary malignant tumor in vagina. METHODS: A retrospective analysis of 42 patients diagnosed with primary malignant tumor in vagina in Peking Union Medical College Hospital (PUMCH) between Jan 1984 and Aug 2006 was performed. RESULTS: Primary malignant tumor accounted for 0.98% (42/4286) in the total gynecological malignant tumors during that period in PUMCH. According to the International Federation of Gynecology and Obstetrics (FIGO) staging system, 19 cases were at stage I, 12 cases at stage II, 5 cases at stage III, and 6 cases at stage IV. Thirteen cases were squamous carcinoma, 13 cases were malignant melanoma, 8 cases were adenocarcinoma, 3 cases were yolk sac tumor and 5 cases were other types. The majority of patients were treated with surgery combined with radiotherapy and chemotherapy. Up to August 2007, 19 cases survived, 18 cases were dead and 5 cases were lost. The longest follow up was 10 years, with the median time of 2 years. The overall 2-year survival rate was 60.6%. For stage I, stage II and stage III - IV, the 2-year survival rates were 71.3%, 58.3% and 29.6% respectively. The 2-year survival rate of patients with squamous carcinoma was 46.8%, malignant melanoma 72.9%, adenocarcinoma 20.0% and patients with yolk sac tumor were all alive tumor-free after 6 - 10 years' follow up. CONCLUSIONS: The prognosis of primary malignant tumor in vagina is affected by clinical stage and histological type. As to malignant melanoma, radical surgery combined with chemotherapy and immunotherapy produce good effects. Patients with yolk sac tumor can be cured only with chemotherapy. As to other types, more treatment experiences are needed.